Therapeutic apparatus



Feb. 13, 1940. L. B. NEWMAN THERAPEUTIC APPARATUS Filed Aug. 29, 1936 UIT ED "STATES I Patente d Feb. 13 1940 PATENT OFFICE THERAPEUTICAPPARATUS Louis B. Newman, Chicago, Ill.

I 15 Claims.

I'his .invention relatesfto therapeutic appar'atus, and.moreparticularly tosuch apparatus as is usedfor the application of heator cold for the destruction of pathogenic micro-organisms 5' infectingan internal or external part of the f human body, or for other purposes,such for instance, for improving the circulation and aiding theresolution of abscesses and other abnormal conditions, and for improvingthe distribution 10* and :action: of medicaments. I, It is known thatmany pathogenic microprganisrns are destroyed by the continuousapplication vof heat thereto at a temperature below theydestructivetemperature for human tissue, and therapeutic apparatus for dealing withsuch micro-organisms is well known. Such apparatus generally. consistsof an applicator in the form ofa thin rubber bag of the requisite shapefor the particular organ of the body to be treated, and means'forcirculating water at the proper temperature through the applicator. Theapplicator is made of thin rubber so that when it is distended orinflated by the hot water it will contact with as'large a proportion aspossible of the surface of the organ being treated.

' One of the great dangers in the use of therapeutic apparatus of theabove character is that of breakage of the thin rubber applicator. Thisalways causes discomfort or severe pain to the 0 patient, and frequentlysevere burns. It is known that the destructive temperatures for thetissue of different parts of the body is not the same, and that the,requisite destructive temperature' for certain pathogenic micro-organ- 5isms is only very little below that which will destroy' the affectedtissue, and may be even above the temperature which will injure moresensitive tissue adjacent the afl'ected tissue.

order to maintain the affected tissue at the proper elevated temperaturethere must be a continuous flow of heat through the applicator to thetissue,

. which means that the temperature on the in side of the applicator mustbe above that on the outside of the applicator, namely above that of thetissue being treated- When it is considered that the temperatureto whichthe tissue is subjected for. the destruction of the pathogenicmicro-organisms is only slightly below that which will result indestruction of the tissue itself, and may be above the maximum safetemperature for adjacent tissue, it will be appreciated that rupture ofthe applicator, withthe consequent I release of the hot water therefrom,is very likely to cause burning of the tissue. Also, the rem leased hotwater will flow into the body beyond Also, in

1 Application August 29, 1936, Serial No. 98,437

the applicator and may seriously burn more sensitive tissue. In additionthere is the danger of infection being carried by the released water, asWell as the possible injury by the water itself. This danger isaggravated by the fact that for 5 many uses the applicator must be madevery thin so that, when it is distended, it will contact the. entireinternal surface of the organ in which it is placed. It is an object ofthis invention to provide a therapeutic apparatus of the above characterwhich is not subject to the dangers above mentioned, as well as others,in the event that the applicator should break. By eliminating thepossible injury resulting from breakage of the applicator it is possibleto use thinner applicators with safety, or to use higher destructivetemperatures without fear that possible breakage of the applicator willcause injurious overheating of the tissue. The above result isaccomplished by using heated air instead of water as the fluid forinflating and carrying heat to the applicator. By circulating hot airinstead of hot water through the applicator a breakage of the applicatorcan do no harm because the specific heat of air at the elevatedtemperature is negligible in comparison with the corresponding heatcarried by water at the same temperature. Furthermore, a breakage of theapplicator will not result in wetting of the patient and consequentembarrassment to both patient and doctor.

It is a further object of the present invention to provide a simple andreliable means for controlling the pressure in the applicator. Thisresult is accomplished by providing a small hand pump for increasing theamount of air in the closed circulating system which includes theapplicator, thereby increasing the pressure and causing distention ofthe applicator. A hand operated relief valve is provided for permittingcontrolled escape or" the air to reduce the pressure in the applicatorfor partially or completely collapsing the same. In addition, a safetyvalve is provided for limiting the pressure. By this arrangement thephysician can inflate the applicator to the desired degree withoutdanger of injuring thepatient, even in the remote contingency that theapplicator should break or tear While it is in position. Having thusproperly inflated the applicator, the physician is assured that thepressure in the system cannot possibly go up, regardless of what mayhappen to the electrical system. At such times the applicator is a partof a closed air system containing a fixed amount of air which ismaintained in circulato Fig. 1.

tion by the fan andis maintained at a proper temperature by the heatingmeans. The attendant can then leave the patient, during treatment,because even if an accident were to happen and the applicator shouldbreak, no possible injury can result.

It is a still further object of the present invention to provide anapplicator so arranged that it may receive a thermometer which willindicate the temperature at the applicator. The thermometer is locatedat the very point in the system where the heat treatment is beingapplied so that the physician knows at all times the exact temperaturebeing applied It is a still further object of the present invention toprovide a new method for increasing the effectiveness of variousmedicaments now applied to the surfaces of human tissue in the treatmentof disease or other pathological conditions. When ointments, drugs, orpowders are applied to body surfaces, or into body cavities for theirtherapeutic or medicinal effects, the action is necessarily slow, andfrequently uncertain. I propose to increase the effectiveness and speedof action of the medicaments by applying heat to the body tissue,thereby causing the natural dilation of'the pores or other tissuesurface, and thus increasing the effectiveness of the medicaments. Thisis particularly important in the treatment of vaginal afflictions.

' By my process, the various medicaments used are introduced, as in thepast, and then the applicator is inserted in place. The heat andpressure of the applicator results in a spreading of the medicamentsover the entire tissue and causes more rapid and effective penetrationof the medicaments.

. It is a still further object of the present invention to use theapparatus above set forth, for treatment where reduced temperatures aredesirable, as well as where elevated temperatures are required. When areduced temperature is desired, the air within the applicator may becooled, as, for instance, by circulating a refrigerant in a coil withinthe closed air circulating system, although it is to be understood thatany other of a plurality of well-known methods of cooling the air may beresorted to.

The attainment of the above and other objects of the present inventionwill be apparent from the following specification taken in conjunctionwith the following drawing forming a part thereof.

' In the drawing:

Fig. 1 is a diagrammatic view illustrating one embodiment of the presentinvention;

Fig. 2 is an enlarged view of that end of the apparatus to which theapplicator is attached;

Fig. 3 is a sectional view taken along the line 3-3 of Fig; 2; and

Figure 4 is a sectional view, in partial elevation, illustrating anotherembodiment of the present invention.

Reference may now be had more particularly The applicator is indicatedat I and comprises a thin rubber bag of a proper shape, depending uponthe particular body cavity for which the applicator is intended, and anapplicator head to which the bag is attached. The bag is of thin rubberso that upon inflation it expands to fill the body cavity in which it isplaced and contacts as large a portion of the surface of the cavity asis possible. The applicator bag illustrated at I is of a shapeparticularly adapted for treatment of the female pelvic region. Theapplicator head is indicated at 2, the applicator bag being secured tothe lower end of the applicator head. A thermometer 3 extends through asuitable opening in the applicator head into the applicator bag, so thatthe thermometer indicates the actual temperature within the applicatorbag. The applicator I is provided with an air inlet opening adapted toreceive a pipe or tube 4, and an air outlet opening adapted to receive apipe or tube 5. The tubes 4 and 5 extend to the control apparatuslocated at a convenient adjacent place and which includes a temperingcasing I for heating or cooling the air, and a fan housing 8, connectedtogether and to the pipes 4 and 5 so as to constitute a closed aircirculating system. Air is moved by the fan 8 through the casing I,thence through the tube or pipe 4,

.through the applicator I, outlet pipe 5 and back to the inlet of thefan. The pressure within this circulating system is determined bythequantity of air in the system. The system is made leakproof to guardagainst escape of air and consequent loss of pressure. Means is providedfor increasing or decreasing the amount of air in the system so that anydesired pressure is obtained. This means comprises a bulb pump I0connected by a tube II to the air circulating system at any desiredpoint, for instance at the casing I. The bulb pump I0 comprises a rubberbulb and a suitable valve arrangement so that upon compression of thebulb the air therein is forced through the tube I I, whereas uponrelease of the pressure on the bulb I0, air is drawn into the bulb fromthe atmosphere through an inlet I2, instead of through the tube II. Theinlet I2 may also be operated manually to permit escape of air from thesystem. This is the usual type of bulb pump used with the ordinaryportable blood pressure determining device. A pressure gauge I4 isprovided for determining the pressure in the system.

An electric motor I5 is provided for operating the fan 8, and a coil I6,hereinafter referred to as a tempering coil, is provided for heating orcooling the air in the circulating system. In the case of an apparatusdesigned for cold treatment, the tempering coil I6 may comprise a coilconnected to receive a refrigerant from a refrigerating system. In thecase of a heat treating ap-' paratus, the coil I6 comprises anelectrical resistance coil. The desired temperature can be changed byoperating a knob I! of an automatic thermostatic control I8. In the caseof an electric system the knob I'I adjusts a resistance in the controlapparatus II.

Reference may now be had more particularly to Fig. 2 showing theconstruction of the ap-' plicator head. The applicator headconsists ofan outer pipe 20 having an enlargement 2I at its lower end for receivingthe applicator I. A bore 22 is formed in the enlargement for receivingthe thermometer 3. The thermometer seals in the bore 22 so that therecanbe no escape of air from the applicator at the point of entrance ofthe thermometer. The pipe 20 is adapted to be connected with a pipe 24by means of a universal coupling 25 suitably gasketed at 26 to preventthe leakage of air. The pipe 24 has two branches, viz: a branch 28 and abranch 29. The branch 28 is adapted to receive a rubber tube 5 at itsouter end and constitutes the airy outlet side of the applicator. Thebranch 29 has a pipe 30 therein which extends through that branch andthrough the pipe 20 to the applicator. The branch 29 is adapted toreceive for therapeutic treatment.

a rubber'tube or pipe 4 which constitutes the air inlet side to theapplicator. The applicator is slipped over the head 2| of the pipe 20and may then be insertedin place for treatment of the patient.Thereafter the physician connects the pipe 29 to the pipe 20 by means ofthe universal connection 25. This subjects the patient to a minimumamount of discomfort during the insertion of the applicator intoposition.

It is apparent from my above description that I have provided a simpleand reliable apparatus By means of this apparatus the treatingtemperature can be changed atwill and with great rapidity. Also, afterthe applicator is inserted in place, the physician does not have tomaneuver the applicator to eliminate air bubbles, such as must be donewith applicators employing water as the heating fluid. Also, in theevent that the applicator should rupture while in use, the patient isnot subject to the possibility of being burnt, nor to the discomfort,annoyance and embarrassment that results when a water-treatingtherapeutic device ruptures. Furthermore,

in the event of rupture of the applicator bag, a

new bag can-quickly be inserted in place and treatment continued. With.therapeutic devices employing water as the heating fluid, this cannotescaped,

be done quickly because of the water that has Not' only must the freshwater be heated, which takes time, but the bed linens must be changed,which takes additional time. This means that the entire effect of theheating, up to the time of the rupture of the applicator,

' maybe lostbecause of the time delay.

Reference may nowbe had to Fig. 4, wherein Ishow, diagrammatically, anapplicator of the type illustrated in Fig. 3, but of a simplerconstruction, in that here the heater is placed directly-in theapplicator, and the air is not circulated through the applicator. Theapplicator is indicated at I, being mounted at the end of a tubularhandle 32, to form a seal-tight fit. The handle ,32-isprovided with anopening 33 whereby air may be forced into the applicator by means of abulb pump H], which is connected to the handle 32 by means of a tube 34.Tempering apparatus 36 is inserted into the applicator, said temperingapparatusbeing sup- :1 ported by the tubular handle 32 and provided witha sealing tube 38 for preventing the escape of air or other gas from theapplicator I through the inlet for the tempering device. The temperingdevice may consist of a cooling coil, when 11 the apparatus is to beused for cooling purposes,

or it may consist of an electric heater when the apparatus is to be usedfor heating purposes. A thermometer 3 is provided for indicating thetemperature within the applicator. A baffle 39 shields the end of thethermometer from the direct influence of the tempering apparatus. In

using the device of Fig. 4, the physician insertsthe applicator in placeand then inflates it the requisite amount. Thereafter, the temperaturewithin the applicator is raised or lowered, depending upon the type oftreatment, by means of the tempering device. If desired, a pressuregauge, such as the gauge I 4 of Fig. 1, may be provided for thispurpose.

While the applicator shown in the drawing is particularly useful forinsertion into a body cavity, it is not limited to such use, as it mayreadily be applied to the exterior surface of the body, wherever heat orcold treatment is desired. Also, the applicator may be made of anyshape,

depending upon the particular body surface where it is to be used.

In compliance with the requirements of the patent statutes, I have hereshown and described a preferred embodiment of my invention. It is,however, to be understood that the invention is not limited to theprecise method here disclosed, nor to the precise method and apparatushere shown and disclosed, it being merely illustrative of the principlesof the invention. What I consider new and desire to secure by LettersPattent is:

1. Therapeutic apparatus comprising an airtight flexible applicator,means for moving a gas through the applicator, and means for changingthe pressure of the gas in the applicator.

2. Therapeutic apparatus comprising a gas system including anapplicator,-means for circulating a gas through the applicator, meansfor controlling the temperature of the gas in the applicator, and meansfor varying the pressure of the gas in the applicator.

3. Therapeutic apparatus comprising a distendable applicator, meansforming a closed, air-tight circulating air system including saidapplicator, means for circulating the air in said system, and means forincreasing the air pressure in said system to distend the applicator.

4. Therapeutic apparatus comprising a distendable applicator, meansforming a closed, airtight, circulating air system including saidapplicator, means for circulating the air in said system, means forincreasing the amount of air in said system to distend the applicator,and means for regulating the temperature of the air in the applicator.

5. In combination with an inflatable applicator having means forming gasinlet and gas outlet openings, connections between the two openings forestablishing a closed gas circulating system including said applicator,means in said system for circulating gas through the applicator, meansfor regulating the temperature of the gas in the system, and means forforcing gas into the system to increase the pressure and thus distendthe applicator.

6. A therapeutic device comprising in combination, an inflatableapplicator having means forming gas inlet and gas outlet openings,connecting means between said openings forming a closed air circulatingsystem including said applicator, a fan in said system for circulatingair through said applicator, a hand operated air pump receiving air fromthe atmosphere and having an outlet connected to said system fordelivering air to the system to increase the pressure in the system fordistending the applicator, means for controlling the temperature of theair in the circulating system comprising an electric heating coil andcontrolling means for controlling the amount of heat generated by thecoil, thermally responsive means located in the applicator forindicating the temperature of the air in the applicator, and a reliefvalve for relieving the pressure in the applicator.

'7. Therapeutic apparatus comprising means forming a gaseous fluidsystem including an applicator having a distendable applicator bag,means for increasing the amount of gas in the entire system forinflating the bag and means for effecting a heating of the bodystructures adjacent the applicator bag, said heating means beingsubstantially spaced from parts of the applicator which come intocontact with parts of the body, and fluid of said system being in saidspace.

8. In combination, a tubular member having a substantially thickened endportion, an inflatable applicator bag having a neck fitting over andembracing the thickenedportion, a thermal responsive member extendingthrough the thickened portion and into the bag, with that part of thethermal responsive member which is outside of the bag and outside of thethickened portion being located adjacent the tubular member whereby thetubular member acts as a protective shield for the thermal responsivemember, and means connected to the tubular member for forcing fluidtherethrough into the bag for inflating the bag.

9. Therapeutic apparatus comprising in combination an air systemincluding an inflatable applicator having an air inlet opening and anair outlet opening, means for moving air through the applicator andincreasing the pressure of the air above atmospheric pressure tomaintain the applicator inflated, said means including an air fanconnected to the air inlet side of the applicator and continuouslyoperable to maintain a continuous movement of air through the applicatorfrom the inlet to the outlet side of the applicator, and means forvarying the temperature of the body structures adjacent the applicatorby varying the temperature of the air in the applicator.

'10. Therapeutic apparatus comprising an airtight flexible applicator,means for moving a gas through the applicator, means for changing thepressure of the gas in the applicator and means for refrigerating thegas.

11. Therapeutic apparatus comprising a distendable applicator, meansforming a closed, airtight, circulating air system including saidapplicator, means for circulating the air in said system, means forincreasing the quantity of air in the system to increase the airpressure of the air in said system to distend the applicator and meansfor cooling the air in said system.

12. Therapeutic apparatus comprising in com bination an air systemincluding an inflatable applicator having an air inlet opening and anair outlet opening, means for moving air through the applicator andincreasing the pressure of the air above atmospheric pressure tomaintain the applicator inflated, said means including an air 'fanconnected to the air inlet side of the applicator and continuouslyoperable to maintain a continuous movement of air through the applicatorfrom the inlet to the outlet side of the applicator, and means forcooling the temperature of the body structures adjacent the applicator,

said last named means comprising means for refrigerating the air.

13. Therapeutic apparatus comprising an airtight flexible applicator,means for moving a gas through the applicator, and means for changingthe pressure of the .gas in the applicator, said flexible applicatorincluding a bag through which the gas is moved and said applicatorhaving inlet and outlet openings for movement of gas simultaneously intoand out of the bag, said bagbeing sufficiently thin and flexible toenable it to conform itself to the shape of an adjacent surface of thehuman body with which it is in contact.

14. Therapeutic apparatus comprising an airtight flexible applicatorincluding a bag adapted to be inserted into a human body cavity, meansfor moving a gas through the applicator and maintaining the gas incontinuous movement within the applicator, means for changing thepressure of the gas in the applicator bag to inflate the bag intoengagement with the inside surface of the body cavity, said bag beingsufiiciently thin and flexible to enable it to conform itselfsubstantially to the shape of the body cavity when inflated and thus tocontact a substantial area of the surface of the body cavity, and meansoutside of the applicator bag for heating the body tissues adjacent thebag to a temperature substantially above body temperature by varying thetemperature of the air in the bag.

15. Therapeutic apparatus for destroying iniectious micro-organisms neara cavity in the human body by elevating the temperature of the infectedregion above the destructive temper ature for the infectiousmicro-organisms but below the temperature at which objectionabledestruction of adjacent human tissue takes place, said apparatuscomprising an air-tight flexible applicator including a bagadapted to beinserted into a body cavity, means for moving a gas through theapplicator and maintaining the gas in continuous movement within theapplicator, means for changing the pressure of the gas in the applicatorto inflate the applicator bag into engagement with the inside surface ofthe body cavity, said bag being sufficiently thin, elastic, and flexibleto enable it to conform itself substantially to the shape of the bodycavity so that when inflated it contacts a substantial area of the bodycavity, and means outside of the applicator bag for heating the gas toraise the temperature of body tissues adjacent the bag sufficient toeffect destruction of infectious micro-orgam- 151115.

LOUIS B. NEWMAN. I5

